The aim of this study was to evaluate the medical and nursing care provided to children in the last 24 hours of life in two Brazilian paediatric intensive care units and analyse the nurses' participation in the decision-making process for life support limitation (LSL). The study was based on an analysis of the patients' medical charts, looking at the medical and nursing care provided in the last 24 hours of life during a 6-month period in the two units, and on semi-structured interviews with 20 nurses to evaluate their participation in LSL decisions. The children were classified into two groups: those who were to receive full cardiopulmonary resuscitation (CPR) and a non-CPR group. A total of 34 deaths occurred during the study period. Of these, 17 (50%) were children that had been in the non-CPR group; there were only 10 recorded LSL plans in their medical charts. In the interviews, only 30% of the nurses mentioned active participation in LSL decisions. In conclusion, the paediatric intensive care nurses in these two Brazilian units did not participate much in LSL decisions, and the care offered in the last hours of life to children with terminal and irreversible illness was not primarily directed toward comfort and alleviating suffering.
This paper aimed at knowing the cultural caesarean representations present in magazines addressed to the laic public. One of the attributions of the nurse is health education. The press is source of informal education. So, the nurse must provide women with subsidies so that they can make decisions with autonomy and knowledge, demystifying or incrementing what is thought about the surgical delivery. Upon analyzing editions of Revista Crescer, two themes have arisen: the “said” and the “not said” about caesarean. Regarding the “said” category, the articles appraise pathologies in the gestation and their inter-occurrences with explicit association between pathologies and the caesarean; the magazine searched for the adequacy of the woman to the hospital routine and softened the caesarean consequences. As to the “not said” category, the magazine did not emphasize the control and prevention of the complications that are inherent to pregnancy and, somehow, led women to opt for the caesarean as the safest mode of delivery.
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